Monday, October 5, 2009

Drugs to be Taken on Empty Stomach

Drugs to be taken on empty stomach should be taken either 1 hour before or 2 hours after meals. However, in the hospital scenario, in order not to confuse patients, we usually cancel the 'selepas' for the label to read 'sebelum makan'.

Here are some common examples of drugs to be taken on empty stomach and the reasons for doing so.

where the oral bioavailability of the drug is reduced by more than 20% by food

6-mercaptopurine

alendronate

atenolol

azithromycin

captopril

ferrous fumarate

indinavir (heavy/large meals only)

d-penicillamine (take with food if GI upset)

dicloxacillin

didanosine

erythromycin base (erythromycin estolate, erythromycin stearate: take with food as drugs may cause a signicicant incidence of gastric side effects)

flucloxacillin

gemfibrozil

isoniazide

perindopril

rifampicin

tacrine

tetracycline

lansoprazole

As gastric acid secretion is maximally stimulated by food ingestion, maximal efficacy of proton pump inhibitors (e.g. omeprazole, pantoprazole, lansoprazole) should be achieved when they are taken before a meal.

where the presence of food reduces the effectiveness of the preparation but is unrelated to absorption

bismuth subcitrate

sucralfate (theoretical)

where the rate of absorption of the drug is significantly reduced by food and clinical effect is related to rapid absorption

3 comments:

Once-daily dosing in the morning is more effective than dosing in the evening for all proton pump inhibitors with respect to the suppression of intragastric acidity and daytime gastric acid secretion in particular, which may result from a better bio-availability being achieved with the morning dose. When higher doses are needed, these drugs must be given twice daily to achieve the optimal suppression of 24 hour intragastric acidity.

administration: disperse tablets in water, orange or apple juice. Stir to form suspension and drink entire contents. Administer at same time each day on empty stomache, 30 min before food. Do not use with aluminium containing antacid.

Subscribe To

Search This Blog

About

A blog by a group of Malaysian pharmacists (hence ‘myPharmacists’; on a side note, ‘myPharmacists’ also means ‘my pharmacists’ – how some people fondly refer to their regular pharmacists) to share their working experience and clinical knowledge with the aspiration to be better pharmacists. This blog also aims to share any pharmacy updates and related issues with fellow pharmacists. Occasional rantings are meant to be taken lightly.

Every day, we are learning and hence, we welcome comments and views from pharmacists out there. We look forward to hear from you at our blog. Alternatively, you can also drop us a line at bpharmer05[at]gmail[dot]com.

Disclaimer: The contents of this blog are for solely for information purpose; they might contain errors and not completely up-to-date. Errors, when pointed out, might not be corrected immediately.